The Feasibility and Reliability of Upper Arm-Worn Apple Watch Heart Rate Monitoring for Surgeons during Surgery: pilot study (Preprint)

Abstract

The well-being of physicians, particularly surgeons, has been largely ignored in the medical field despite their high levels of stress. Wrist-worn heart rate monitors have become more prevalent, but cannot be worn during surgery.

This study aims to examine the feasibility of using an Apple Watch worn on the upper arm of a surgeon to collect heart rate data during surgery.

This study used two identical Apple Watch Series 8 devices to monitor the heart rate of surgeons during robotic-assisted surgery. Heart rate data was collected from the wrist-worn and the upper arm-worn, and statistical analysis included calculating the mean difference and standard deviation of difference between the two devices, constructing Bland-Altman plots, assessing accuracy based on mean absolute error (MAE) and mean absolute percentage error (MAPE), and calculating intraclass correlation coefficient. Demographic information and surgical data were also collected.

The MAE for the whole group and for subjects A, B, C and D were 3.63, 3.58, 2.70, 3.93 and 4.28, respectively, and the MAPE were 3.58%, 3.34%, 2.42%, 4.58% and 4.00%, respectively. Bland-Altman plots and scatter plots showed no systematic error when comparing the heart rate measurements obtained from the upper arm-worn and the wrist-worn Apple Watches. The ICC for subjects A, B, C and D were 0.559, 0.651, 0.508, 0.563 (P<.001).Following the previously mentioned limits, this can be interpreted as moderate reliability.

This study suggests that the upper arm-worn is a viable alternative site for monitoring heart rate during surgery using an Apple Watch. The agreement and reliability between the measurements obtained from the upper arm-worn and the wrist-worn were good, with no systematic error and a high level of accuracy. The findings of this study have important implications for improving data collection and management of the physical and mental demands of surgeons during surgery, where wearing a watch on the wrist is not feasible.

This study was approved by the Institutional Review Board (IRB) of Gunma Prefectural Cancer Center (IRB number 405-04030).